Christopher Ritchlin1, Jose U Scher2. 1. Allergy, Immunology and Rheumatology Division, Center for Musculoskeletal Research, University of Rochester Medical Center, Box 695, Rochester, NY, 14642, USA. christopher_ritchlin@urmc.rochester.edu. 2. Department of Medicine, Division of Rheumatology and Psoriatic Arthritis Center, New York University School of Medicine, New York, NY, USA.
Abstract
PURPOSE OF REVIEW: The therapeutic response to biologic agents in psoriasis is significantly higher than observed in psoriatic arthritis (PsA). In this review, specific actions to improve treatment outcomes in PsA are discussed. RECENT FINDINGS: Increased understanding of disease pathogenesis derived from improved preclinical models and advances in cell-based and molecular technologies provide new tools to identify therapeutic targets. In addition to the important contributions of metabolic comorbidities, chronic pain and the lack of a diagnostic biomarker signal the need for new strategies to improve outcomes. Potential strategies include the following: (1) discover a novel pathway or cellular subset, (2) apply stratification biomarkers to individualize therapy, (3) preclinical intervention, (4) combination therapy, (5) lifestyle modification, (6) address chronic pain and fatigue, and (7) multidisciplinary care. The future holds great promise for enhanced treatment responses in PsA based on improved understanding of individual variation in disease pathophysiology coupled with comprehensive and integrated treatment programs.
PURPOSE OF REVIEW: The therapeutic response to biologic agents in psoriasis is significantly higher than observed in psoriatic arthritis (PsA). In this review, specific actions to improve treatment outcomes in PsA are discussed. RECENT FINDINGS: Increased understanding of disease pathogenesis derived from improved preclinical models and advances in cell-based and molecular technologies provide new tools to identify therapeutic targets. In addition to the important contributions of metabolic comorbidities, chronic pain and the lack of a diagnostic biomarker signal the need for new strategies to improve outcomes. Potential strategies include the following: (1) discover a novel pathway or cellular subset, (2) apply stratification biomarkers to individualize therapy, (3) preclinical intervention, (4) combination therapy, (5) lifestyle modification, (6) address chronic pain and fatigue, and (7) multidisciplinary care. The future holds great promise for enhanced treatment responses in PsA based on improved understanding of individual variation in disease pathophysiology coupled with comprehensive and integrated treatment programs.
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Authors: Laura T Donlin; Deepak A Rao; Kevin Wei; Kamil Slowikowski; Mandy J McGeachy; Jason D Turner; Nida Meednu; Fumitaka Mizoguchi; Maria Gutierrez-Arcelus; David J Lieb; Joshua Keegan; Kaylin Muskat; Joshua Hillman; Cristina Rozo; Edd Ricker; Thomas M Eisenhaure; Shuqiang Li; Edward P Browne; Adam Chicoine; Danielle Sutherby; Akiko Noma; Chad Nusbaum; Stephen Kelly; Alessandra B Pernis; Lionel B Ivashkiv; Susan M Goodman; William H Robinson; Paul J Utz; James A Lederer; Ellen M Gravallese; Brendan F Boyce; Nir Hacohen; Costantino Pitzalis; Peter K Gregersen; Gary S Firestein; Soumya Raychaudhuri; Larry W Moreland; V Michael Holers; Vivian P Bykerk; Andrew Filer; David L Boyle; Michael B Brenner; Jennifer H Anolik Journal: Arthritis Res Ther Date: 2018-07-11 Impact factor: 5.156
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